Test questions

Question 1

As a result of an endocardial infection, your patient suffers a rupture of the chordae tendineae of the right ventricle. This is likely to result in an alteration of blood flow that will cause what and where would it be heard?

Answer 1

Bicuspid regurgitation.

Heard in the right atrium as a systolic murmur (right fifth intercostal space at the sternal border)

Question 2

Where is the structure responsible for controlling the length of time between atrial systole and ventricular systole?

Answer 2

He is referring to the AV node which is found in the interatrial septum

Question 3

Which birth development defects will cause cyanosis at brith

Answer 3

All related to the Aorticopulmonary septum formation:
1. transposition of the great arteries

2. Pulmonary deviation of the aorticopulmonary septum
3. persistent truncus arteriosus.

Question 4

Why is the incidence of patent ductus arteriosus higher in pre-term babies than in full term babies?

Answer 4

Underdevelopment of alveoli of the lung in pre-term babies results in inadequate oxygenation of the blood in the pulmonary circuit.

Also level of circulating prostaglandin is too high in preterm babies to allow closure of the ductus

Question 5

What is increased levels of B-type natriuretic factor indicative of?

Answer 5

Congestive heart failure

Question 6

Edrophonium is a cholinesterase inhibitor used to test for myasthenia gravis. Which of the following is a likely side-effect that could directly result from administration of edrophonium?

Answer 6

Cholinesterase inhibitor would inhibit the degeneration of cholines. This likely points to the function of parasympathetics. Bradycardia would be one likely result.

Question 7

Epicardial cronoary vasoconstrction can be prevented if a certain drug is administered prior to a procedure. Which class of drug would be most effective for this purpose?

Answer 7

Alpha-adrenergic antagonist

Question 8

What is the best way to lower cardiac sympathetic tone?

Answer 8

Beta1 antagonist

Question 9

A healthy 30 year old woman has been undergoing intesne exercise. Relative to resting conditions, what would happen to her ESPVR

Answer 9

(End systolic volume is decreased)
(End diastolic volume is increased)
Cardiac output is increased.
The ESPVR is shifted upward and leftward.

Question 10

A 50 year old develops bradycardia due to SA node dysfunction resulting in junctional escape rhythm and retrograde atrial conduction. Which finding would most likley be in leads 2 and aVF

Answer 10

Increased RR interval

Inverse P waves (retrograde atrial conduction)

Question 11

What would blocking L-type calcium channel do?

Answer 11

It would reduce contractility of the cardiac ventricular myocyte

Question 12

Peak force of contraction of the left ventricular myocytes is best represented by which phase on a EKG

Answer 12

S phase

Question 13

At which phase of the EKG would the first heart sound be heard.

Answer 13

Closure of the AV valves will be heard at R phase

Question 14

Which conditions lead to a widened QRS complex?

Answer 14

1. Bundle branch block
2. PVCs
3. Ventricular tachycardia

Question 15

What are the four characteristics of ventricular fibrillation?

Answer 15

1. can be caused by reentry
2. no discernible P waves
3. uncoordinated, rapid myofibril contractions
4. uncoordinated ventricular depolarizations

Question 16

What are the three characteristics of premature ventricular contractions

Answer 16

1. No p wave associated with QRS
2. Widened QRS
3. may involve reentry

Question 17

what are the 5 qualities of AV junctional tachycardia

Answer 17

Regular rhythm
Supraventricular tachycardia 
may involve reentry
Inverted P waves 
AV nodal dysfunction

Question 18

What are the six characteristics of Atrial fibrillation

Answer 18

1. frequent origin is Right and left superior pulmonary veins
2. no P waves
3. some atrial impulses are conducted to ventricles
4. non-coordinated rapid myofibril contractions (atrial)
5. supraventricular tachycardia
6. may involve reentry

Question 19

What four things are in the posterior mediastinum?

Answer 19

1. Thoracic aorta
2. thoracic duct
3. Azygos vein
4. Esophagus

Question 20

What is the only thing in the anterior mediastinum?

Answer 20

Thymus

Question 21

What are in the superior mediastinum?

Answer 21

1. left/right brachiocephalic veins
2. superior vena cava
3. thoracic duct
4. ascending aorta
5. left common carotid artery
6. brachiocephalic trunk
7. left subclavian artery
8. descending aorta
9. aortic arch
10. vagus nerve
11. recurrent laryngeal
12. ligamentum arteriosus

Question 22

What does the left coronary artery supply?

Answer 22

The left ventricle, left atrium and interventricular septum.

Question 23

What does the right coronary artery supply?

Answer 23

The right ventricle
right atrium
SA node
AV node

Question 24

Where does the right vagus nerve pass relative to the arch of the azygos?

What does the septomarginal trabecula contain?

Answer 24

The right vagus goes medial to it

The moderator band contains conducting fibers of the right bundle branch which is a shortcut to the anterior papillary muscle.